DESCRIPTION: The death of a child presents major challenges to parents'spiritual wellbeing. Our long-term goal is to understand the spiritual needs of bereaved parents, the ways in which bereaved parents'spiritual needs change over time, and the manner and extent that spiritually based interventions affect parents'health during bereavement. The objective of this R03 application, which is the next step toward attainment of our long-term goal, is to develop a reliable and valid scale to assess the spiritual wellbeing of bereaved parents. A scale is needed to assess bereaved parents'spiritual wellbeing because such a scale would facilitate the development of new spiritually based interventions that would help to prevent the mental and physical ailments that often complicate grief. We plan to accomplish the objective of this application by pursuing two specific aims. Aim 1 will triangulate the themes of bereaved parents'spiritual needs identified in our preliminary studies. Focus groups will be conducted with parents who experienced the death of their child in a pediatric intensive care unit (PICU) and with hospital chaplains who routinely care for bereaved families. Focus group discussions will be digitally recorded, transcribed and inductively analyzed to identify and describe parents'spiritual needs. Findings will be compared to the spiritual needs identified in our prior in-depth interviews with bereaved parents. Aim 2 will develop and validate the Bereaved Parent Spirituality Questionnaire (BPSQ), a scale to measure bereaved parents'spiritual wellbeing. BPSQ items will be based on the spiritual themes triangulated in Aim 1. The Wayne State University Center to Advance Palliative Care Excellence, an interdisciplinary team of end-of-life experts, will assess the content validity of the BPSQ items. In a multicenter study, the BPSQ and other related, previously validated questionnaires will be administered to 250 parents whose child died in one of 5 PICUs. Psychometric analyses including assessment of dimensionality and differential item functioning will be performed on the BPSQ. Construct and convergent validity will be evaluated by investigating relationships between the BPSQ and other validated questionnaires. The research will provide greater understanding of bereaved parents'spiritual needs and produce a reliable, valid and clinically relevant spiritual wellbeing scale specific for bereaved parents. The research is innovative because it addresses an understudied population (i.e., bereaved parents) and focuses on an important and understudied aspect of adjustment to loss (i.e., spirituality). The research is significant because it will lay the foundation for subsequent definitive studies of parental bereavement. The research is expected to lead to an R01 application that will support studies examining the effect of new spiritually based interventions on bereaved parents'mental and physical health.